NPIMap

Organization Active NPI

Four Branches Therapy & Wellness, LLC

  • Community/Behavioral Health Agency
  • Wichita, KS
National Provider Identifier
1114297314
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LCMFT 756 Issued in KS
Legal business name
FOUR BRANCHES THERAPY & WELLNESS, LLC
Practice address
11828 W Central Ave Ste 104
Wichita, KS 67212-5178
Phone
(316) 648-8886
NPI assigned
Jan 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tracy D Stuever, LCMFTNPI 1558394791
Title
Owner/Therapist
Phone
(316) 648-8886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LCMFT 756 KS Primary

Addresses

Primary practice location

11828 W Central Ave Ste 104
Wichita, KS 67212-5178

Mailing address

11828 W Central Ave Ste 104
Wichita, KS 67212-5178
Phone (316) 648-8886

Other identifiers 1

IdentifierTypeStateIssuer
200671720BMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Tracy@fourbranchestherapists.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636675200000",
    "number": "1114297314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11828 W CENTRAL AVE STE 104",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672125178",
            "telephone_number": "316-648-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11828 W CENTRAL AVE STE 104",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672125178",
            "telephone_number": "316-648-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR BRANCHES THERAPY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "STUEVER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "316-648-8886",
        "authorized_official_credential": "LCMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KS",
            "license": "LCMFT 756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200671720B",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tracy@fourbranchestherapists.com",
            "affiliation": "N",
            "address_1": "11828 W Central Ave Ste 104",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672125178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.